As someone who cares about their health, you listen when your doctor recommends a procedure. But how can you be sure that your doctor’s suggestions are based on your own best interests rather than their own? Recent reports highlight the growing concern over unnecessary atherectomies—a minimally invasive procedure used to remove plaque buildup from an artery. As if undergoing the physical and emotional stress of a medical procedure isn’t bad enough, some patients have experienced limb loss and other severe injuries as a result of what many are calling unnecessary atherectomies.
Doctors have a legal and ethical duty to provide patients with all the information they need to make informed decisions about their health. As we’ve discussed in previous posts, physicians who recommend unnecessary surgeries may violate this duty. This is especially the case where an unnecessary medical procedure results in long-term injuries, such as amputation. Patients who have undergone an atherectomy and subsequently suffered related health issues may be able to pursue a medical malpractice claim against a provider. Due to the complexities these cases present, patients interested in learning more about an atherectomy lawsuit should reach out to an experienced medical malpractice lawyer to discuss their rights.
Background on Atherectomies
Researchers have warned the Centers for Medicare and Medicaid (CMS) for years about the growing accounts of injuries, amputations, and deaths related to unnecessary outpatient vascular care. Atherectomies are one of the most concerning vascular procedures. An atherectomy is a procedure in which doctors use a catheter to remove plaque buildup in a patient’s arteries, often when the plaque is very hard or a blockage still exists after exhausting other alternatives. However, some providers are recommending and performing atherectomies when they may not be necessary, despite the risks the procedure involves.
Leading experts report that the problem’s origin is two-fold, suggesting that the government’s decision to provide unconditional and inflated payments for vascular procedures in conjunction with doctors’ decisions to perform unnecessary surgery has resulted in a significant increase in medical issues resulting from atherectomies.
Although technological advances have allowed patients to avoid open surgery, the alternative has left some patients with debilitating injuries, including long-term pain and even limb loss. Patients are now asserting that they are victims of the era of profit-driven medicine and have experienced significant damages as a result.
Why Is the Number of Atherectomies Increasing?
Some experts claim that CMS’s changes to its Medicare payment structure have incentivized doctors to perform risky and unnecessary outpatient heart procedures, specifically atherectomies. While atherectomies might be necessary for individuals with severe hardened plaque, or a previous history of angioplasty and stenting, physicians have been performing this procedure in place of more conservative options.
Despite evidence suggesting that there may be cheaper, safer, and more effective alternatives to atherectomies, the Centers for Medicare and Medicaid did not change how it compensates doctors for performing atherectomies. As a result, the data indicates the number of atherectomies has doubled, and physician payments have tripled.
Researchers are urging CMS to take steps to address this growing and deadly problem by investigating physicians with high rates of billing. Additionally, experts are calling on CMS to evaluate and reduce reimbursements for atherectomies. However, to date, CMS has not modified its payment structure. And doctors who have been disciplined have only incurred minor fines relative to the significant profit they have made off performing unnecessary surgeries.
Are Vascular Doctors Responsible for Botched Heart Procedures?
Patients have begun coming forward with claims that they have experienced serious injuries from botched and unnecessary vascular surgery. CMS data shows a small cohort of physicians responsible for over one-third of all atherectomies and government reimbursements. Patients who have aired their complaints to licensing boards have learned that some physicians performing these procedures were found to have engaged in “medically unnecessary and invasive vascular procedures” and failed to meet the relevant standards of care for a large proportion of patients they treated. Some physicians seem to create opportunities for quick profit booms by taking advantage of their patients’ fear of invasive surgery and lack of medical knowledge.
Dangerous Atherectomies Lead to Limb Loss
Patients have led the charge toward accountability for physicians who have performed unnecessary heart procedures. These individuals have alleged a variety of claims that primarily involve physicians prioritizing profit while neglecting to provide their patients with appropriate care and treatment.
Some patients claim that they were pressured into atherectomies only to receive a second opinion that indicated that their conditions were mild, unrelated to heart problems, and easily treatable. Others who underwent the procedures have experienced worsening symptoms, including the inability to walk and debilitating pain. Some patients awoke from their atherectomies only to discover they had a limb amputated because something went awry during their procedure.
Many patients who experienced botched atherectomies have been unable to return to work and require costly in-home care for their daily activities. However, most concerning is that many amputees are left with the physical and psychological scars of their doctors’ negligence.
Whistleblower Rewards for Reporting Financial Misconduct and Fraud at Vascular Centers
Medicare and Medicaid cannot review every claim that a doctor submits before making payments. Accordingly, the federal government places an excessive amount of trust in physicians and other healthcare providers to submit truthful and accurate claims. However, the stark reality is that many healthcare professionals are willing to bend and break the rules to increase their profit margins.
Many who work in health care understand the ramifications of financial misconduct and fraud at medical facilities. Not only do the taxpayers bear a significant brunt of the practice’s misconduct, but patients are also at a real risk of harm. As such, under the False Claims Act, employees and staff at vascular clinics who alert the government to accounts of substantiated financial misconduct and fraud at their facilities may be entitled to compensation.
Given the high rates of unnecessary atherectomies, whistleblowers may alert the government when their employer billed for atherectomies that were not rendered or not medically necessary. Whistleblowers who successfully alert the government to atherectomy fraud under the False Claims Act may be entitled to up to 30% of what the government collects.
In this way, patients and employees of vascular clinics each have the ability to hold doctors accountable for ordering unnecessary atherectomies.
